Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03831 | Date 23/02/2019 |
| Token No | SM/19-20/14078 26/11/2019 | Serial | 085 Last Visit: 26/11/2019 |
| Patient Name | Miss DIPIKA DAS | Contact No | 7044717545 |
| Address | 24 DIARA GOBINDOPUR | Age | 11 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||